Clinical Cardiology Alert – November 1, 2022

Cerebral Embolic Protection Device Disappoints in TAVR/Stroke Trial

In this largest-to-date randomized trial of stroke prevention in transcatheter aortic valve replacement patients, use of the Sentinel cerebral embolic protection device did not significantly affect the incidence of periprocedural stroke.

The Dental Procedure-Infective Endocarditis Link Controversy Continues

Infective endocarditis was more common with dental surgery or tooth extractions in the preceding four weeks in high-risk patients. Researchers abrogated this risk with antibiotic prophylaxis before the procedure.

Is Routine Stress Testing After Coronary Revascularization Necessary?

A multicentered study of routine stress testing at one year post-percutaneous coronary revascularization compared to usual care in patients with at least one high-risk coronary anatomic or clinical feature failed to show improved clinical outcomes at two years follow-up.

Ejection Fraction and Outcomes in Bicuspid Aortic Valve Disease

A study of patients with bicuspid aortic valve and moderate or more aortic valve disease revealed the cutpoint for considering aortic valve replacement should be moved from < 50% to < 60% in the guidelines.

Importance of Medication Adherence in Ischemic Heart Disease

The results of a subanalysis of the ISCHEMIA trial indicated about one-quarter of patients in both conservative and invasive strategy groups were nonadherent to recommended medical therapy at baseline. Nonadherence was associated with worse health status in both groups at baseline and after one year.